Provider Demographics
NPI:1538029855
Name:NURTURED MINDS LCSW, PLLC
Entity type:Organization
Organization Name:NURTURED MINDS LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-595-8168
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:NY
Mailing Address - Zip Code:12972-0260
Mailing Address - Country:US
Mailing Address - Phone:518-595-8168
Mailing Address - Fax:518-595-8168
Practice Address - Street 1:686 BEAR SWAMP RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:NY
Practice Address - Zip Code:12972-4804
Practice Address - Country:US
Practice Address - Phone:518-578-1961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty